PUBLICLY FINANCED HEALTH INSURANCE IS ONLY PART OF THE PICTURE IN THE NATIONAL HEALTH PROBLEM. WE MUST RECOGNIZE THE IMPORTANCE OF ENVIRONMENTAL FACTORS, AND THE NEED FOR A SUPPLY-STRATEGY TO CORRECT THE MALDISTRIBUTION OF HEALTH CARE RESOURCES BROUGHT ABOUT BY THE PRESENT SYSTEM. THE CANADIAN EXPERIENCE SHOULD BE OF INTEREST AND VALUE.
An evaluation of the use of national health insurance (NHI) as a public policy to improve US health care. Experiences of publicly financed NHI in Quebec Province specifically, & throughout Canada, between 1965 & 1975, & of the publicly financed Medicare & Medicaid programs in the US are analyzed, focusing on the impact on these programs of cost, access, & equity issues. Various insights are presented concerning future adoption of publicly financed NHI in the US: (1) it would bring forth a sudden initial increase in health care expenditures, (2) a continued higher rate of health care expenditures would ensue, (3) access to health care would be more equitably distributed, & (4) there would be some redistribution of the financial burden of health care across income classes. These limitations to the NHI strategy are noted: (A) it will not solve the health care cost escalation problem, (B) it will not correct the maldistribution of health care resources sufficiently to guarantee health care for all, & (C) it will only modify, but not eliminate, the regressive & inequitable system of paying for health care. It is argued that a much broader view of the factors that influence health status (including lifestyle, ecological deterioration, education, & nutrition) needs to be taken. 2 Tables. Modified HA.
